EXAM 3 1996 QUESTIONS
M. Grasso, S. Robinson
Neuromuscular blocking agents, Anti-emetics,
Sedatives & Hypnotics, Anti-anxiety agentsNS
<Q 9-16> <Q 17-24> <Q 25-32> <Q 33-40>
Select the letter of the BEST single answer.
1. Normal neuromuscular transmission involves ion transfer, as Na+ and Ca++ move _____ and K+ moves _____.
a. intracellularly; intracellularly
b. extracellularly; intracellularly
c. out of the synaptic cleft; into the synaptic cleft
d. out of skeletal muscle; into skeletal muscle
2. All neuromuscular blockers resemble acetylcholine in containing _____
A. B. C. D.
a. more than one negatively charged quaternary ammonium group
b. less than two positively charged tertiary ammonium groups
c. just one positively charged quaternary ammonium group
d. one or more positively charged quaternary ammonium groups
3. Both depolarizing and non-depolarizing neuromuscular blockers attach to the alpha subunits of the nicotinic cholinergic postjunctional receptor, but they differ in that:
a. the depolarizing neuromuscular blockers are antagonists and depolarize cell membranes
b. the non-depolarizing neuromuscular blockers are antagonists and cause no configurational change in the receptor
c. the non-depolarizing neuromuscular blockers work mainly by blocking the ion channels directly
d. the depolarizing neuromuscular blockers are agonists and cause blockade by sustained repolarization of the cell membranes
4. Characteristics of a depolarizing neuromuscular blockade include all of the following EXCEPT:
a. TOF ratio less than 0.7
b. a decreased amplitude but sustained response to continuous stimulus
c. decreased response to single twitch stimulus
d. none of the above
5.Succinylcholine has an onset of _____ and a duration of _______.
a. 0.5-1.0 sec, 30-40 min
b. 30-60 sec, 6-8 min
c. 30-60 sec, 12-18 min
d. 2-3 min, 6-8 min
6. Succinylcholine is eliminated by ______; presence of ______ will ______.
a. hepatic microsomal enzymes; liver disease; delay recovery
b. acetylcholinesterase hydrolysis; anticholinesterases; not effect recovery time
c. pseudocholinesterase hydrolysis; atypical plasma cholinesterase; greatly increase succinylcholine duration of action
d. none of the above
7. Administration of succinylcholine is associated with a normal _____ increase in the serum potassium level; excessive increases can be seen in patients with _____.
a. 0.5-1.0 mEq/L; burns, denervated muscle, massive soft tissue trauma
b. 0.5-2.0 mEq/L; burns, denervated muscle
c. 1.0-1.5 mEq/dL; burns, cerebral palsy, bed rest
d. minimal; renal failure, cerebral palsy
8. Characteristics of a non-depolarizing neuromuscular blockade include none of the following EXCEPT:
a. TOF ratio greater than 0.7
b. fasciculations of skeletal muscle at onset
c. decreased response to single twitch stimulus
d. absence of post-tetanic facilitation
